Vessels and nerves of the gluteal region and posterior thigh

The gluteal region and posterior thigh contains an abundance of large and small muscles, and coursing through these muscles is a vast network of nerves and vessels.

These nerves mainly originate from the lumbosacral plexus, whereas the vascular supply derives either directly or indirectly from the internal iliac arteries.

Ok, so let’s start with the nerves of the gluteal region and posterior thigh.

Most nerves of the lower limb arise from the lumbosacral plexus, a network of nerves derived from the roots of lumbar and sacral spinal nerves that branch out to form the nerves of the lower limb.

However, out of all the resulting nerves, the gluteal region and posterior thigh is only supplied by the cluneal nerves, superior and inferior gluteal nerves, the sciatic and pudendal nerves, the posterior cutaneous nerve of the thigh, and nerves to quadratus femoris and to obturator internus.

Let's start off with the cluneal nerves which innervate the skin of the gluteal region.

The superior cluneal nerves arise from L1-L3, and supply the skin of the superior buttock.

The middle cluneal nerve arises from S1-S3 and supplies skin over the sacrum and adjacent area of the buttocks.

And finally the inferior cluneal nerve is a branch of the posterior cutaneous nerve of the thigh from S2-S3 and supplies skin over the inferior half of the buttocks as far as the greater trochanter.

Next, there’s the superior gluteal nerve which is formed by the L4, L5, and S1 nerve roots.

The nerve courses laterally between the gluteus medius and minimus along the deep branch of the superior gluteal artery, and it exits the pelvis through the greater sciatic foramen above the piriformis muscle.

It then goes on to innervate the the gluteus medius, the gluteus minimus, and the tensor fasciae latae.